Medication non-adherence compromises treatment efficacy, worsens patient health outcomes, and increases overall healthcare costs. In the United States alone, one-third to one-half of patients do not take their medications as prescribed by their physician. Estimates by the World Health Organization report that the average compliance rate in developed countries is 50%. In addition, medication non-adherence, suboptimal prescribing, and improper drug administration are responsible for an estimated $290 billion in “otherwise avoidable medical spending.” These costs arise from increased physician and hospital treatment, as nonadherent patients are three times more likely to visit a doctor and incur $2,000 more in hospital treatment annually when compared to adherent patients. “21st Century Intelligent pharmacy project: the importance of medication adherence.” Center for Health Transformation (2010).
There have been many attempts to improve medication adherence. For example, GlowCaps® from Vitality, Inc., Los Angeles, Calif. is a cap that screws-on to most standard, prescription medicine bottles. When a medication becomes due, both the cap and a plug-in nightlight flash orange to alert the patient of their dose. The cap transmits data to the plug-in device which ultimately communicates data over a cellular network. Patients receive a series of reminders after their medication is due, culminating in a reminder phone call to the patient or caregiver if the pill bottle is not opened. In addition to monitoring compliance, the GlowCaps® cap can also send a request for a new prescription via a push button that lies under the cap. Patients receive a call shortly after pushing the button, confirming their prescription.
MedPod, from Daya Medicals, Inc., Miami, Fla. (“DayaMed”), is a rechargeable and portable dispenser of pre-sorted medication. The MedPod reminds patients and/or their caregivers of missed doses via text, email, or by phone. LED lighting and audible reminders alert patients that they need to take their dose. DayaMed produces self-contained cartridges that can be loaded directly into the Medpod. These cartridges are shipped directly to patients, eliminating the need to manually load the device. Medpod is also equipped with a calling functionality that allows patients to directly contact their pharmacist or provider.
U.S. Pat. No. 8,744,620 B2, U.S. Pat. No. 8,193,918 B1, and U.S. Patent Publication No. 2013/0002795 A1, assigned to MedMinder Systems, Inc., Needham, Mass. (“MedMinder”), describe a technology enabled pill box that separates a patient's medications into 4 compartments for each day of the week. The compartments contain cups which in turn contain pills. Manipulating a lid, and/or placing into, removing from, or replacing a cup in a correct compartment are detected and compared to a medication dispensing compliance schedule. If a lid is not opened or a cup is not removed within a designated time frame, the patient receives an auditory prompt in addition to subsequent phone calls, text messages, and emails. The pill box can be equipped with wireless pendant that serves as a medical alert that connects patients to a medical professional at a certified monitoring center. MedMinder sells two basic types of pill boxes, one whose compartments remain locked until a dose is due and another whose compartments remain unlocked. Additionally, a patient can opt for MedMinder to issue trays, which can be filled by a caretaker to ease the burden of loading the pill box. The compartments of this tray contain the pill cups that the box would otherwise use.
U.S. Pat. No. 8,754,769, U.S. Patent No. Patent Publication No. 2014/0347175, U.S. Patent Publication No. 2014/024094, and U.S. Patent Publication No. 2013/0222135, assigned to AdhereTech, Inc., New York, N.Y., describe smart pill bottles that track the exact amount of medication inside the bottle in real-time, wirelessly sends the data into the cloud, and reminds patients to take their dose via automated call or text message. In addition, the pill bottle is equipped with LED lighting to alert patients directly that a medication dose is due.
A digital sensor that can be directly embedded into solid medication pills has been developed by Proteus Digital Health, Inc., Redwood City, Calif. (“Proteus”). The patient ingests a sensor which subsequently communicates with a wearable patch sensor on the patient's skin. From there data can be sent to Proteus software that allows monitoring of compliance by patients and caregivers. The sensor technology is currently only approved for use in an accessory pill that is taken alongside a patient's regular medications.